Rate and spectrum of incidental findings on CT pulmonary angiogram of COVID-19 patients

ABSTRACT

Introduction: Patients admitted with COVID-19 infection and had suspected pulmonary embolism were investigated with CT pulmonary angiogram(CTPA). Apart from the features of COVID pneumonitis, other incidental findings can be reported on the scan. Aim(s) This study illustrates the rate and spectrum of incidental findings on CTPA performed on patients admitted with COVID-19 in a busy district general hospital. Method(s) Electronic patient record and CTPA report of patients admitted with COVID-19 confirmed from SARS-COV2 PCR test were retrospectively analysed using Allscripts Gateway and Sectra software respectively between March 2020 to March 2021. Descriptive and statistical data analysis were undertaken in Excel and GraphPad Prism software. Result(s) 874 patients with COVID-19 with median age of 69 yrs were studied and 218 patients had CTPA (25%). 219 Incidental findings were noted in 112 (51%) patients who had CTPA. Patients with incidental findings are older (68 yrs vs 59yrs, p value 0.0005). 35 patients(16%) were found to have pulmonary embolism in our cohort. Conclusion: This study illustrates that incidental findings are common when COVID-19 patients had CTPA scans, and these patients were older. These incidental findings were both varied and clinically significant. This would increase the pressure on respiratory and cardiology services to investigate these incidental findings, further management and subsequent follow up.